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Objective:To observe the effect of catgut-embedding therapy at five neck points in the treatment of cervical spondylotic arteriopathy（CSA） and analyze its effects on the hemodynamics of patients with CSA.Methods:Using the computer randomization method,72 patients with CSA were divided into a catgutembedding therapy group（n=36,none dropped out） and a western medication group（n=36,none dropped out）.In the catgut-embedding therapy group,the therapy was applied to five neck points,i.e.bilateral Jǐngjiājǐ（颈夹脊）at C5,bilateral Jǐngjiājǐ（颈夹脊）at C6,and Dàzhuī（大椎GV14） once a week.One3-week treatment session was required.In the western medication group,flunarizine hydrochloride 5 mg capsules were administered orally once daily for 3 weeks.Efficacy was assessed before and after 3 weeks treatment using a functional evaluation scale for cervical spondylotic arteriopathy（FS-CSA）.Changes in vertebral-basilar arterial hemodynamics,serum nitric oxide（NO） level,and plasma endothelin（ET） level were detected.Results:Efficacy was assessed when the treatment session was completed.The total efficacy rate was significantly higher in the catgut-embedding therapy group（86.1%） than in the western medication group（61.1%;P ＜0.01）.The after treatment FS-CSA score was reduced compared with baseline score in both groups（P ＜0.05）,and the reduction in the catgut-embedding therapy group was superior to that in the Western medication group（P ＜0.05）.Compared with baseline,the flow velocity and pulsatility index of the bilateral vertebral and basilar arteries increased at each period in both groups（P ＜0.05） except for the left systolic velocity of the vertebral artery after treatment.The increase in the catgut-embedding therapy group was greater than that in the western medication group（P ＜0.05）.After treatment,the serum NO concentration was increased and the plasma ET concentration was reduced compared to baseline in both groups（P ＜0.05）,while the improvements in the catgut-embedding therapy group were superior to those in the western medication group（P ＜0.05）.Conclusion:The clinical efficacy in the catgut-embedding therapy group was superior to that in the western medication group.Catgut-embedding therapy at five neck points may effectively improve psychological and functional conditions,promote vertebral basilar arterial supply,and relieve clinical symptoms in patients with CSA.